“All strong souls first go to hell before they do the healing of the world they came here for. If we are lucky, we return to help those still trapped below.” — Clarissa Pinkola Estés


The world of Medicine feels like it’s going to hell in a handbasket these days. It’s the breakdown of all we hoped for, or previously thought we knew.

We’re into our 3rd year of pandemic, with over 900,000 people in the US having died of COVID so far. Every crack in our healthcare system has yawned wider, or blown apart completely. Human lives are falling through the fissures left by staffing shortages, full hospitals, sheer volume of outpatients needing care, cranky tempers — and in some cases, exits from the medical profession through choice, retirement, illness, or even suicide. We’ve had decades of burnout in Medicine before this, and now it seems like a volcanic eruption with ongoing lava flow.

Though this landscape feels dark and ominous, it’s fortunately not all there is.

From listening deeply to physicians all over, I know that most still love caring for patients. We made a sacred commitment to do whatever we can, to help others heal. This moves us to accomplish the seemingly impossible in treatment, triage, and technical expertise. When we can’t deliver the kind of care we know is needed though, it tears us apart inside and out. Yet we still show up, and keep trying. How is this even possible?

Applicable wisdom can be found in unexpected places, if our minds and hearts are open.

Did you know that in Hawaiian indigenous tradition, Pele — the goddess of fire, lightning, and volcanoes — is also the creator of the Hawaiian islands? As destructive as volcanic eruption may be, it’s also how new land physically grows. Known as a goddess of transformation, Pele (and her activities) can appear in many different forms. The volcano Kilauea on the Big Island of Hawaii is a prime example of this. It’s been flowing for years, similar to the experience of “burnout” in Medicine. Whole neighborhoods have been demolished and covered over with lava, yet the land itself extends further than it ever did before. The accompanying image (from photographer Brian Harig) shows what’s happening there.

What gives me hope in all this? Like many of my colleagues, I am one who has been through hell. And I’ve learned that the same invisible force that erupts volcanoes, also rotates planets, blooms roses, and moves birds to migrate. It urges humans forward as well. The energy of life in us grows, creates, and transforms. It wonders, loves, and grieves along the way. It searches for solid footing, especially when times feel volatile and uncertain.

At times like these, we need deeper stability points than what a volcano can blow apart. Ironically, our most solid footing may be in a currently invisible, formless, spiritual (not religious) space within our very consciousness. Imagination and possibility live there, along with fresh responses to what we’re facing right now. These responses are “invisible” until someone brings them forth from the unknown, into the known.

What if it’s possible for ANY of us to experience this place within ourselves? And then apply what comes from there, naturally, sensibly, and effectively?

I know it’s possible.

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